A nurse is teaching a client who has mitral valve stenosis that has not responded to pharmacological therapies about other treatment options. Which of the following statements should the nurse include in their teaching?

A. Lower blood pressure: Lowering blood pressure may be indicated in certain cases of brain herniation to reduce cerebral perfusion pressure (CPP) and decrease cerebral blood volume. However, this intervention should be carefully titrated based on the individual client's condition and should not be applied universally as a treatment for brain herniation. In some cases, lowering blood pressure may exacerbate cerebral ischemia and worsen neurological outcomes.

B. Decrease sedation: Reducing sedation may be necessary to allow for neurological assessment and evaluation of the client's neurological status. However, it is not a direct treatment for brain herniation. Sedation may need to be adjusted to facilitate neurological monitoring and assessment of the client's response to treatment interventions. Excessive sedation can obscure neurological signs and symptoms, making it difficult to assess the effectiveness of interventions aimed at reducing ICP.

C. Hyperventilate the client: Hyperventilation is a potential intervention for managing brain herniation as it helps temporarily lower intracranial pressure (ICP) by inducing cerebral vasoconstriction. By increasing the rate and depth of breathing, hyperventilation reduces the partial pressure of carbon dioxide (PaCO2) in the blood, leading to vasoconstriction of cerebral blood vessels and a decrease in cerebral blood flow. This can help alleviate symptoms associated with increased ICP and reduce the risk of further brain injury.

D. Reduce the temperature in the room: Therapeutic hypothermia may be considered as a treatment option in certain cases of brain injury to reduce metabolic demand, lower ICP, and attenuate secondary brain injury. However, simply reducing the temperature in the room without implementing therapeutic hypothermia protocols is unlikely to effectively manage brain herniation. Therapeutic hypothermia requires careful monitoring and control of the client's body temperature to prevent complications. Additionally, hypothermia alone may not provide immediate relief from increased ICP associated with brain herniation.

A. Comply with compression therapy: Compression therapy is commonly used in the management of peripheral vascular disease (PVD), not valvular heart disease. It involves applying external pressure to the limbs to improve circulation and reduce edema. While this intervention may be relevant for a client with PVD, it is not specific to valvular heart disease.

B. Monitor wounds on lower extremities: Monitoring wounds on lower extremities is important for clients with peripheral vascular disease (PVD) to assess for signs of poor wound healing, infection, or tissue ischemia. However, it is not directly related to valvular heart disease. Therefore, while wound monitoring may be appropriate for this client, it is not specific to valvular heart disease education.

C. Take antiplatelet medications as ordered: Antiplatelet medications, such as aspirin or clopidogrel, are commonly prescribed for clients with peripheral vascular disease (PVD) to reduce the risk of thrombotic events and improve blood flow. However, they are not typically indicated as a primary treatment for valvular heart disease. While some clients with valvular heart disease may have comorbidities that warrant antiplatelet therapy, it is not specific to valvular heart disease education.

D. Valvular heart disease involves dysfunction of one or more heart valves, leading to impaired blood flow within the heart. The nurse should educate the client on monitoring for the gradual onset of symptoms related to valvular heart disease. These symptoms may include dyspnea (shortness of breath), fatigue, palpitations, chest discomfort, and edema. Monitoring for these symptoms allows for early detection of disease progression or exacerbation, prompting timely intervention and management.